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MAR19 48046

Maternity Services 250 Bon Air Road, Greenbrae, CA 94904 1-415-925-7575 | www.mymarinhealth.org

Birth Preferences PlanThank you for choosing to have your baby at MarinHealthSM Medical Center. We appreciate the fact that every birth is a unique and intimate experience, and we have the expert staff, powerful medical affiliations, and excellent quality and safety standards to take the best possible care of you and your baby.

As the big day approaches, you may be thinking about ways to make your baby’s birth experience more meaningful for you and your loved ones. We encourage you to take the time to fill out this form so we can help provide the environment that will make you most comfortable—physically and emotionally.

This plan is not a contract and can be modified at any time. It’s important to understand that every birth is different, so it’s not possible to predict the course of your labor. We ask that you be prepared to adjust your birth preferences if it becomes medically necessary to do so. As long as your safety or that of your baby is not compromised, our goal is to stay as true to your plan as possible.

OUR PHILOSOPHY AND PRACTICESWe adhere to the following evidence-based standards of care:

• Encourage physiological birth

• Encourage movement while in labor

• Encourage eating and drinking in labor, unless otherwise medically indicated

• Support women who choose to have an unmedicated birth and encourage them to bring support people to help make this possible

• Support women who desire pain medication with 24/7 availability of anesthesia (these options are discussed upon your arrival in labor and can be modified at any time)

• Do not perform routine enemas, shaving or episiotomies

• Routinely delay clamping the umbilical cord after delivery, unless baby is having difficulty transitioning

• Believe breast milk is the best nutrition for your baby and that breastfeeding promotes unique health benefits for mom and baby that last a lifetime

• Support breastfeeding with an International Board Certified Lactation Consultant (IBCLC) as needed

• Do not offer babies formula without a medical reason and parents’ permission

• Encourage skin-to-skin contact as soon as the baby is born, as long as the baby is transitioning safely

• Routinely delay procedures and first bath to enhance bonding and promote breastfeeding

Your Individual Birth PreferencesPlease mark your preferences and bring this with you to your next prenatal appointment as well as upon arrival to Maternity Services.

LABOR ENVIRONMENT

I would like to have the following:

My support team in the room:

Dim lights and soft voices

To be able to play my own music

COMFORT MEASURES

I would like to have the following:

Essential oils

A TENS unit (Transcutaneous Electrical Nerve Stimulation)

To discuss my medication options if you see that I am having difficulty coping with the discomforts of labor

IV narcotics

Nitrous oxide

An epidural (regional anesthesia)

Hydrotherapy in the shower

Hydrotherapy in a labor tub I rented (or the hospital tub, if it is available)

Intermittent fetal monitoring unless continuous monitoring is medically necessary

LABOR INTERVENTIONS

I would like to:

Discuss natural options for helping labor progress, if necessary

Limit vaginal exams, unless medically indicated

Have intermittent fetal monitoring unless continuous monitoring is medically necessary

Have a saline lock placed when my blood is drawn during hospital admission. I understand this will allow IV access for medications and hydration, if needed, but will allow me freedom of movement during labor.

Not have an IV placed on admission, unless medically indicated. I understand that I will need to stay hydrated by drinking clear liquids and may need an IV later in the labor process.

DELIVERY

When pushing, I would like to have the following options:

To “labor down” until I have the urge to push

To be offered coaching if needed

To be given a choice to push in whatever position feels most comfortable (such as standing, side lying, squatting, semi-sitting, or hands and knees). I understand that this may not be possible if I have an epidural.

To use a mirror to see the baby as it crowns

If a cesarean birth is necessary, I would like to have the following:

My partner present (please list name here):

The baby placed skin-to-skin post delivery (unless the baby is not transitioning well)

After the birth, I would like to have the following:

To keep my placenta (I will sign a consent, as well as provide a container and arrange to have it removed from MarinHealth Medical Center within 2 hours after delivery)

Cord blood collected for banking (I have provided a cord collection kit), if possible

My partner to cut the umbilical cord

My partner to stay with the baby during routine care procedures (if the baby and I need to be separated)

My partner to take photos and/or video of the birth

My partner to announce the sex of our baby

Other

POSTPARTUM

Once my baby is born, I would like to:

Receive a massage from our Integrative Wellness Center (if available)

Receive visitors right away

Wait until I’ve had a chance to recover and bond with my baby

NEWBORN MEDICATIONS (Waivers will need to be signed at the hospital)

I do not want Erythromycin eye ointment but I do agree to Vitamin K injection

I do not want Erythromycin eye ointment or the Vitamin K injection. I am aware that the pediatrician will speak to me about the risks of declining these medicines.

I do not want the Hep B vaccine in the hospital. I have discussed an alternative vaccine schedule with my pediatrician.

CIRCUMCISION

If I have a boy, I plan to:

Not circumcise

Have him circumcised before leaving the hospital (note that vitamin K will be required)

FEEDINGS

I would like to:

Breastfeed my baby

Bottle feed my baby breast milk (and receive assistance from the Lactation Consultants, as needed)

Bottle feed my baby formula. I have been counseled about the benefits of breastfeeding and the risks of formula and how to prepare it

ADDITIONAL BIRTH PREFERENCES

I would like to have the following:

Other Helpful InformationUCSF Benioff Children’s Hospital at MarinHealth Medical CenterWe have teamed up with UCSF Benioff Children’s Hospital to offer Marin families the finest pediatric care available. Now, you have access to the expertise of a renowned pediatric hospital closer to home. Our collaboration enables us to offer:

• UCSF Health Neonatologists available

• A specialty clinic including experts in pediatric cardiology, gastroenterology, neurology, pulmonology, orthopedics and eating disorders

• A prenatal diagnostic center staffed with specialists in high-risk obstetrics

• Access to all the resources of a top-ranked children’s hospital

Breastfeeding SupportBreastfeeding is one of the most important decisions a woman makes for her child. Our Lactation Services and companion BabyNook Store have been helping mothers get started with a good breastfeeding routine for many years. We are delighted to report that our initiation rates (percentage of moms who choose to breastfeed) are consistently around 99 percent! Our Lactation Services staff consists of Registered Nurses and Internationally Board Certified Lactation Consultants. Our goal is to help women with breastfeeding and parenting through education, counseling and support.

Lactation Services available by appointment. Location: Floor 4, Room 4215 Phone: 1-415-925-7522

BabyNook StoreThe BabyNook has a variety of clothes, supplies, toys and gifts for mom and baby. We also offer low-cost pumps, nursing bras, bustiers and pillows. Our staff has plenty of experience with nursing moms and can help find the best pump for you. Our pumps are competitively priced and we also offer them to rent. As an extra convenience, we even stock spare parts for Medela pumps. We explain how to assemble and use the pump, and how to safely store breast milk. The hospital’s non-profit status allows us to keep our prices low and all proceeds go right back into the Women’s and Pediatric Care Programs at MarinHealth Medical Center.

Location: Floor 4, Room 4216 Hours: Monday – Friday, 10:30 am – 4:30 pm; Saturday, 10:30 am – 1:30 pm; Closed Sundays and HolidaysPhone: 1-415-925-7474

Support Groups and ClassesNew babies bring a lot of changes, and not just the diaper kind! Our childbirth preparation classes can help parents get ready for the new arrival. In addition, these classes provide an opportunity to meet other new parents or parents-to-be. Classes include Childbirth Series, Infant Care Series, New Father Class, Child and Infant CPR & Safety, and Mom’s Support Group. We also offer a Postpartum Support group.

For information, call 1-415-925-7522 or visit www.mymarinhealth.org.